| NPI | 1316160625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX N9820) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TX N9820) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2024-11-13 |